QA straight male friend practices sounding and has for years. I am pretty sure he does other things that he isn't telling anyone about—not even his wife. He has some medical questions about sounding. I am a pediatric nurse, so he brought his concerns to me, but the questions are totally outside my area of expertise. Nothing emergency-room-worthy is going on, but he needs answers and refuses to speak with his regular MD about sounding. I am wondering how to find an MD in his area who would be knowledgeable and nonjudgmental. —Needs Useful Referral Soon

PS: Thank you for your advice over the years. Because of you, I am comfortable with the questions he asked me even if I did not have the answers.

AThe National Coalition for Sexual Freedom maintains a Kink Aware Professionals Directory on its website, ncsfreedom.org. The doctors, counselors, lawyers, real estate agents, etc, aren't vetted by the NCSF, so inclusion on the list isn't a recommendation. But it would be a good place for your friend to start looking for an irregular MD, someone he can open up to about sounding and whatever else he's doing. In the meantime, I asked a doc for some thoughts about the risks and rewards of sounding.

"Sounding refers to the insertion of foreign bodies into the urethra," said Dr. Stephen H. King, a board-certified urologist. "Under controlled medical conditions, urethral sounds, which are typically curved and sterilized metallic or plastic rods, are gently inserted onto the urethra in order to dilate a stricture that blocks the flow of urine out of the bladder. The lining of the urethra is typically very sensitive and delicate, and this procedure can be quite uncomfortable for most people."

But not everyone with a metallic or plastic rod sticking out of his urethra right now is experiencing discomfort. "Some people, likely a significant minority, derive sexual pleasure from urethral stimulation," said Dr. King. "This includes both men and women. Sounders [not to be confused with Seattle's soccer players!] have been known to insert a wide variety of objects, including but not limited to catheters, tubes, beads, pencils, batteries, drill bits, and even the head of a decapitated snake. Yes, the latter has been reported."

I think we all need a moment to process that last detail. Someone found the head of a decapitated snake—or someone found a snake and decapitated it—and thought: "You know what? I'm going to stick this in my urethra." And now we'll never be able to forget it. Deep breaths, everybody. Let our shared trauma bring us closer together, not drive us apart.

OK! Back to your question, NURS: Just how dangerous is sounding?

"Some sounders end up in emergency rooms to remove a stuck object, leading to interesting X-rays and many good party conversations for us urologists," said Dr. King. "But there is very limited medical literature on this topic beyond mostly case studies. However, one recent survey study associated recreational sounding with general high-risk behaviors and increased risk of STIs. Additional complications can include bleeding, infection, urethral stricture, perforation, and erectile dysfunction. Some of these issues may cause long-term impairments or require surgical correction."

A couple qualifiers from a nonmedical nonprofessional (me): Sounding by itself doesn't lead to higher rates of STIs. While urethral rawness would place a person at higher risk of contracting an STI should he be exposed to one, it's the propensity toward high-risk behaviors that places sounders at greater risk of contracting STIs, not the sounding itself.

Also, people who don't get objects stuck in their urethras—sounders who don't progress to larger and larger objects before finally moving on to heads from decapitated snakes—don't make appearances in emergency rooms, the medical literature, or urologists' party conversations. The sample here is by its nature skewed, so while shoving a metal rod into your urethra is more dangerous than not shoving a metal rod into your urethra, it might not be as dangerous as the limited medical literature would seem to suggest. "My guess is there are many people who sound without significant problems," said Dr. King.

QMy friend's boyfriend has a virginity fetish. His birthday is coming up, and she'd love to surprise him with some virginity bleeds. It won't be a regular thing, so she's OK with a bit of pain and discomfort. And it won't be during her period, so that obvious solution is out. She asked for my advice—I'm the local sex guru—but this one has me stumped. —Happy Hymen Hunting

AGood news, HHH! Your friend doesn't have to endure pain and discomfort to treat her boyfriend to a few "virginity bleeds" on his birthday.

"An artificial hymen also known as artificial virginity kit (and popularly referred to as a Chinese hymen or fake hymen) is a type of prosthetic membrane created for the purpose of simulating an intact human hymen," reads the highly disturbing copy at hymenshop.net. "Insert the artificial hymen into your vagina carefully. . . . When your lover penetrate [sic], it will ooze out a liquid that appears like blood, not too much but just the right amount. Add in a few moans and groans and you will pass through undetectable!"

As creepy as the boyfriend's fetish might seem, the fact that some women have to use these artificial hymens under duress—women who need to "pass" themselves off as virgins on their wedding nights—is far, far creepier than a woman using one to indulge her boyfriend's kink.

QI'm a 29-year-old gay man. I recently ended a ten-year relationship that was vanilla and lackluster sexually. I'm now thrilled to be exploring sex with a new boyfriend (of four months) who is GGG and as kinky as I am. The issue is that my boyfriend wants me to hit him and give him a bloody nose during sex. While this sounds hot, it worries me because he was abused as a child, and I'm afraid this might trigger something negative for him. He keeps bringing this up, and I want to do it for him. What do you think? —Just a Love Tap

AI think you should shove a couple of artificial hymens up your boyfriend's nose and hit him just hard enough to break them, JALT, because punching someone in the face is dangerous. You could break his nose, for starters, and you could kill him, for finishers. But if this is something he simply must experience, and if he'll find someone else to do it to him if you won't, here are a couple of questions you need to ask him first: Has he done this before? If so, did it bring back unpleasant memories of his abuse? And does he have health insurance?